Sleep-disordered breathing and cardiovascular disorders.
Sleep-disordered breathing and cardiovascular disorders.
复制标题
DOI：
--
复制
发表时间：
2010-10
期刊：
影响因子：
2.5
通讯作者：
R. Budhiraja;P. Budhiraja;S. Quan
中科院分区：
文献类型：
--
作者：
R. Budhiraja;P. Budhiraja;S. Quan
令人信服的数据表明，睡眠呼吸障碍 (SDB) 与心血管疾病之间存在密切关联。阻塞性睡眠呼吸暂停 (OSA) 和高血压之间的关联最为一致。流行病学和临床研究为 OSA 在高血压中的病因学作用提供了证据，与肥胖无关。此外，一些研究表明通过治疗睡眠呼吸暂停可以改善高血压。新出现的数据还表明 OSA 在导致冠状动脉疾病中发挥着作用。有证据表明，持续气道正压通气 (CPAP) 治疗可改善动脉粥样硬化的早期症状，并可能阻止进展为临床上重要的心血管疾病，这也支持了这种关联。 SDB（OSA 和中枢性睡眠呼吸暂停）常见于心力衰竭患者。 OSA 可能是发生心力衰竭的危险因素。目前的数据并没有为 SDB 治疗是否会改善心力衰竭患者的生存或其他终点提供一致的证据，目前正在进行更大规模的试验以更好地阐明这种关系。大量证据还表明 SDB 会增加各种心律失常的风险。使用 CPAP 治疗 SDB 似乎可以显着降低这种风险。最后，多项研究表明 SDB 是中风的危险因素。然而，SDB 治疗是否可以降低中风风险仍有待确定。总之，有说服力的数据提供了睡眠呼吸障碍与多种心血管疾病之间存在关联（可能是因果关系）的证据。大型随机对照试验将进一步帮助证实这种关联并阐明 SDB 治疗的心血管益处。
Compelling data demonstrate a strong association between sleep-disordered breathing (SDB) and cardiovascular disorders. The association is most consistent between obstructive sleep apnea (OSA) and hypertension. Epidemiologic and clinic-based studies provide evidence for an etiological role of OSA in hypertension, independent of obesity. Furthermore, several studies suggest amelioration of hypertension with therapy for sleep apnea. Emerging data also suggest a role for OSA in causing coronary artery disease. This association is bolstered by evidence suggesting that continuous positive airway pressure (CPAP) therapy improves early signs of atherosclerosis and may impede progression to clinically important cardiovascular disease. SDB (both OSA and central sleep apnea) is frequently observed in patients with heart failure. OSA may be a risk factor for incident heart failure. The current data do not provide consistent evidence for whether treatment of SDB will improve survival or other end points in patients with heart failure, and larger trials are currently underway to better elucidate that relationship. Substantial evidence also links SDB to an increased risk of various arrhythmias. Treatment of SDB with CPAP appears to significantly attenuate that risk. Finally, several studies suggest SDB as a risk factor for stroke. Whether treatment of SDB reduces stroke risk, however, remains to be determined. In conclusion, persuasive data provide evidence for an association, probably causal, between sleep-disordered breathing and several cardiovascular disorders. Large randomized controlled trials will further help confirm the association and elucidate the cardiovascular benefits of SDB therapy.